Healthcare Provider Details

I. General information

NPI: 1427559368
Provider Name (Legal Business Name): SAENZ DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 06/17/2023
Certification Date: 06/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 W 29TH ST
HIALEAH FL
33012-5606
US

IV. Provider business mailing address

752 W 29TH ST
HIALEAH FL
33012-5606
US

V. Phone/Fax

Practice location:
  • Phone: 305-885-9786
  • Fax: 305-885-7682
Mailing address:
  • Phone: 305-885-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROGER ANTONIO SAENZ
Title or Position: PRESIDENT
Credential: DDS
Phone: 305-898-9228